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Pitfalls in Single-Bundle Anterior Cruciate Ligament Reconstruction with the Flexible Reamer System by Seung-Yup Lee, Jae-Gyoon Kim, Ki-Mo Jang, and Hong-Chul.

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Presentation on theme: "Pitfalls in Single-Bundle Anterior Cruciate Ligament Reconstruction with the Flexible Reamer System by Seung-Yup Lee, Jae-Gyoon Kim, Ki-Mo Jang, and Hong-Chul."— Presentation transcript:

1 Pitfalls in Single-Bundle Anterior Cruciate Ligament Reconstruction with the Flexible Reamer System by Seung-Yup Lee, Jae-Gyoon Kim, Ki-Mo Jang, and Hong-Chul Lim JBJS Case Connect Volume 4(4):e95 October 22, 2014 ©2014 by The Journal of Bone and Joint Surgery, Inc.

2 If the tibial footprint of the ACL is completely debrided, the curved femoral drill guide can rest comfortably on the tibial plateau with a 45° superolateral trajectory. Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

3 Bulky tibial remnants of the ACL (arrow) may interfere with the curved femoral drill guide and not allow it to rest at a superolateral trajectory of 45° (dashed arrow). Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

4 In the patients described in Case 1 and Case 2, 6-mm (top) and 7-mm (bottom) flexible reamers, respectively, were broken. Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

5 Breakage of the flexible guide pin in Case 2. Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

6 The broken 7-mm flexible reamer was removed through the anteromedial portal with use of wire- holding forceps. Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

7 Postoperative CT reveals posterior wall blowout (arrow) in Case 1. Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

8 An epiphyseal scar (arrowheads) could cause increased resistance (arrow) during femoral reaming. Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

9 As noted, posterior cortex blowout occurred in Case 1. Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

10 A change in knee flexion after flexible pin placement (arrowheads) would cause acute bending of the flexible guide pin (arrows). Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

11 During flexible pin placement (arrowheads), a change in the position of the curved drill guide (closed black arrow) might cause acute bending of the flexible pin (open arrows). Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95 ©2014 by The Journal of Bone and Joint Surgery, Inc.

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